Hip Dislocation

A. #1. What is the injury sustained? (2 marks)

• 
  Posterior (1 mark) hip dislocation (1 mark)
  
  

B. #2. What is the typical position of the limb in this injury? (2 marks)

• 
  Shortened, 0.5 marks; internal rotation, 0.5 marks; adducted, 0.5 marks; flexed, 0.5 marks
  
  

C. #3. What nerve injury is likely to be associated with this injury and how would you assess it clinically? (3 marks)

• 
  Sciatic nerve (2 marks)
  

• Check for foot drop / Assess for dorsiflexion of toes and ankle (1 mark)
  
  

D. #4. What are the management steps in the Emergency Department? List 3. (3 marks)

• 
  Document neurovascular status (1 mark),
  

• Manual reduction & immobilization (1 mark)
  

• Check X-ray (1 mark)
  

• Traction (1mark)
  

• Abduction pillow (1 mark)
  

• Hip precautions (1 mark)
  
  

(Any 3, 1 mark each)

Bigelow's technique,    manipulation and reduction under conscious sedation (IV fentanyl 25mcg and midazolam 2-5mg) - reduction by abduction followed by external rotation of the right hip -------  student answer